Osteochondral Lesions of the Subtalar Joint: Clinical Outcomes in 11 Patients.

Autor:	Buck TMF; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands., Butler JJ; Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Azam MT; Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Ter Laak Bolk C; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands., Rikken QGH; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands., Weiss MB; Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Dahmen J; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands., Stufkens SAS; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands., Kennedy JG; Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Kerkhoffs GMMJ; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands.; Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.; Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam UMC, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Cartilage [Cartilage] 2024 Mar; Vol. 15 (1), pp. 16-25. Date of Electronic Publication: 2023 Oct 05.
DOI:	10.1177/19476035231200339
Abstrakt:	Objective: The purpose of this retrospective case series was to evaluate clinical outcomes following both conservative treatment and arthroscopic bone marrow stimulation (BMS) for the management of symptomatic subtalar osteochondral lesions (OCLs). Design: All symptomatic subtalar OCLs with a minimum of 12 months follow-up having undergone either a conservative management or arthroscopic procedure were included. Patient-reported outcomes were collected via questionnaires consisting of the Foot and Ankle Outcome Score (FAOS), Numeric Rating Scale (NRS) of pain in rest, during walking, during stair climbing, and during running. In addition, return to sports data, return to work data, reoperations, and complications were collected and assessed. In total, 11 patients across 2 academic institutions were included (3 males, 8 females). The median age was 43 years (interquartile range [IQR]: 32-53). Results: All patients underwent conservative treatment first; in addition, 9 patients underwent subtalar arthroscopic debridement with or without BMS. The median follow-up time was 15 months (IQR: 14-100). In the surgically treated group, the median NRS scores were 2 (IQR: 1-3) during rest, 3 (IQR: 2-4) during walking, 4 (IQR: 4-5) during stair climbing, 5 (IQR: 4-5) during running and the median FAOS score at final follow-up was 74 (IQR: 65-83). In the conservatively treated patients, the median NRS scores were all 0 (IQR: 0-0) and the median FAOS scores were 90 (IQR: 85-94). In the group of surgical treated patients, 4 were able to return to the same level of sports, 2 returned to a lower level of sports. Both conservatively treated patients returned to the sport and the same level of prior participation. All patients except one in the surgical group returned to work. Conclusions: This retrospective case series demonstrated that a high number of patients converted to surgery after initial conservative treatment. In addition, debridement and BMS show good clinical outcomes for the management of symptomatic subtalar OCLs at short-term follow-up. No complications nor secondary surgical procedures were noted in the surgically treated group. The high rate of failure of conservative treatment suggests that surgical intervention for symptomatic subtalar OCLs can be the primary treatment strategy; however, further research is warranted in light of the small number of patients. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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